Religious Service Attendance Reduces Risk of Diseases of Despair

Overview

This study found that greater attendance at religious services is consistently associated with a lower risk of diseases of despair, including painkiller abuse, suicidal ideation, and binge drinking. Multiple rigorous analytic methods, including sibling fixed effects and instrumental variable analyses, support a likely causal protective effect of religiosity on these outcomes.

Background

Deaths of despair—suicide, drug overdoses, and alcohol-related liver disease—have risen sharply in the US since the early 2000s, contributing to declining life expectancy. These deaths disproportionately affect individuals with lower education and have increased among both white and black populations. Concurrently, religiosity has declined substantially, with fewer people attending religious services. Religiosity may protect against despair-related diseases by fostering social capital and moral norms that discourage substance abuse and suicidal behavior. However, prior research has been limited by confounding factors and has rarely used causal inference methods.

Data Highlights

Key Findings

• Greater religious service attendance is significantly associated with lower risk of a composite outcome of painkiller abuse, suicidal ideation, and weekly binge drinking.
• Regression analyses across waves 3 to 5 consistently show negative associations between religiosity and diseases of despair.
• Sibling fixed effects models, controlling for family-level confounders, confirm the protective association.
• Instrumental variable analyses yield even stronger negative associations, supporting a likely causal effect.
• Cross-lag panel models demonstrate temporal precedence of religiosity reducing subsequent diseases of despair.
• The decline in religious service attendance over recent decades likely contributed to the rise in deaths of despair in the US.

Clinical Implications

Clinicians should consider the role of social and spiritual factors, including religious engagement, as potential protective elements against substance abuse and suicidal behaviors. Encouraging patients to engage in supportive community or faith-based activities may help reduce risks associated with diseases of despair. Public health interventions might also benefit from addressing declines in religiosity as part of comprehensive strategies to combat rising despair-related morbidity.

Conclusion

Robust evidence from multiple analytic approaches indicates that religious service attendance reduces the risk of diseases of despair. The secular decline in religiosity may be an important contributor to the increasing burden of these conditions in the United States.

References

1. Case & Deaton 2020 -- Deaths of Despair and the Future of Capitalism
2. Add Health Study Documentation
3. Religious Service Attendance and Health Outcomes Literature